[Application of modified urethral separation method in artificial urethral sphincter implantation and its influence on intraoperative urethral pressure profilometry].

Objective: To explore the application of modified urethral separation method in artificial urethral sphincter (AUS) implantation in patients with stress urinary incontinence (SUI), and its influence on the results of urethral pressure profilometry. Methods: A prospective collection of clinical data was conducted on 25 patients with stress urinary incontinence who underwent modified urethral separation method in AUS implantation and underwent urethral pressure profilometry in Beijing Hospital, Beijing Jishuitan Hospital Affiliated to Capital Medical University and the Second Hospital Affiliated to Tianjin Medical University from March 2019 to June 2023. The improved urethral separation method was to borrow part of the white membrane tissue of the cavernous body while freeing the dorsal side of the cavernous body of the urethra. The circumference of the urethra, sleeve size, and urethral pressure were recorded, the patient's autonomous urinary control before and after surgery and the changes of the international consultation on incontinence questionnaire-short form (ICI-Q-SF) score, incontinence quality of life questionnaire (I-QoL) score, urinary frequency score, nocturia score were compared. Follow-up was conducted in the clinic or by telephone at 1, 3, 6, and 12 months after activation of the device, and once a year thereafter. Local skin status and urine control were assessed, residual urine volume was measured by ultrasound and subjective score scale was completed. Results: All patients were male, aged 27-85 (65.8±15.7) years old. The circumference of the cuff used in this study was 4.0 cm in 4 patients (16.0%), 4.5 cm in 16 patients (64.0%), 5.0 cm in 4 patients (16.0%), and 5.5 cm in 1 patient (4.0%). Among them, the urethral circumference matched the cuff size in 14 cases (56.0%), the urethral circumference was smaller than the cuff size in 4 cases (16.0%), and the urethral circumference was larger than the cuff size in 7 cases (28.0%). Preoperative urodynamic examination showed that the maximum urethral pressure (MUP) was (78.0±25.9) cmH2O, (1 cmH2O=0.098 kPa) and the maximum urethral closure pressure (MUCP) was (53.4±26.6) cmH2O. The MUP of AUS device in the inactivated state was (88.0±26.5) cmH2O, which was not significantly higher than that before operation (P>0.05). The MUCP was (68.2±24.5) cmH2O, which was significantly higher than that before operation (P<0.05). The MUP and MUCP of the AUS device in the activated state were (146.6±25.2) cmH2O and (123.0±28.3) cmH2O, which were significantly higher than those before surgery and in the inactivated state (both P<0.001). All patients in the group reached the social urinary control standards at the first month of device activation. During a follow-up period of 2-50 months, 22 patients (88.0%) used the initial AUS device and all met social urinary control standards. The AUS device was replaced in 1 case. One patient died of cerebrovascular accident. One patient removed the device due to complications. The number of pads [M (Q1, Q3)] used in 25 patients before and after operation was 4.5 (3.0, 6.5) and 1 (0, 1) respectively, with statistically significant differences (P<0.001). ICI-Q-SF score, I-QoL score, urinary frequency score and nocturia score of 25 patients were significantly improved after surgery (all P<0.05). The incidence of postoperative complications was 20.0% (5/25), including 2 cases of painless hematuria, 1 case of infection, 1 case of urethral erosion, and 1 case of dysuria. Except for one patient who experienced urethral erosion and had his sleeve removed, the remaining four patients regained social urination control with active support treatment, and no symptoms recurred until the last follow-up. Conclusion: The modified urethral separation method has no significant effect on urethral pressure in patients with SUI, and can increase the volume of peri-urethral tissue in the cuff, thereby reducing the risk of intraoperative urethral injury and the incidence of postoperative urethral erosion.

MTHFR C677T polymorphism, homocysteine, burden, and location of AMI and ACI.

OBJECTIVE: We aimed to investigate the relationship between homocysteine levels and MTHFR C677T polymorphisms and acute ischemic vascular events and focused on the differential effects of the MTHFR C677T polymorphisms on the burden and location of AMI and ACI. PATIENTS AND METHODS: 102 acute cerebral infarction (ACI) and acute myocardial infarction (AMI) patients who were admitted to the First Hospital of Jilin University in northeast China as the patient group, 83 healthy people who were hospitalized during the same period served as a control group. MTHFR C677T genotypes were identified via Polymerase Chain Reaction (PCR)-Fluorescent Probe Method. RESULTS: Patient group had higher serum homocysteine levels (p=0.013), lower serum folic acid (p<0.001), and Vit B12 levels (p=0.004) compared to the control group. Homocysteine levels in the patient group with the TT genotypes of the MTHFR C677T polymorphisms were higher than those with the CC and CT genotypes (p<0.05). Folic acid levels in the patients with TT genotypes were lower than those with the CC genotypes (p<0.05), but not in the control group (p>0.05). There were negative and significant associations between serum homocysteine levels and serum vitamin B12 levels in the control group (r=-0.234, p=0.033), but not between serum homocysteine levels and serum folic acid levels (r=-0.103, p=0.355). Conversely, there was a negative and significant association between serum homocysteine levels and serum folic acid levels in the patients' group (r=-0.257, p=0.01), but not between serum homocysteine levels and serum vitamin B12 levels (r=-0.185, p=0.64). No statistically significant differences in MTHFR C677T genotype and C/T alleles distribution were investigated between the patient and control group (p>0.05). The MTHFR C677T polymorphism did not differentially affect the burden and location of AMI and ACI. CONCLUSIONS: Homocysteine played a common role in atherosclerosis-related acute ischemic vascular events. These correlations were modified by MTHFR C677T polymorphisms and influenced by folic acid levels. The MTHFR C677T polymorphisms were not directly related to acute ischemic vascular events, nor did they differentially affect the burden and location of AMI and ACI.

[Bipolar androgen therapy followed by immune checkpoint inhibitors in metastatic castration resistant prostate cancer: A report of 4 cases].

The relationship between androgen and prostate cancer treatment has plagued the field of urologic oncology. To investigate the efficacy and safety of bipolar androgen therapy (BAT) followed by immune checkpoint inhibitor therapy in patients with metastatic castration resistant prostate cancer (mCRPC). In August 2020, Beijing Hospital conducted an investigator-initiated study: Bipolar androgen therapy followed by immune checkpoint inhibitor therapy in metastatic castration resistant prostate cancer. Up to now, the study has included 4 patients who completed the entire cycle of treatment. The mean age of the patients was 74.5 (68 to 82) years old, the mean prostate-specific antigen (PSA) was 20.8 (9.9 to 8.36) µg/L, the mean testosterone was 0.50 (0.00 to 1.81) µg/L, and the Gleason score were 10 and 9, 7, 7 respectively. The pain scale score before treatment was 1.5 (1 to 2). In this study, 4 patients completed the entire cycle of treatment, and the treatment effect of the patients showed great heterogeneity. PSA in case 1 decreased from 24.0 µg/L to 0.47 µg/L, testosterone increased from 0.175 6 µg/L to 2.62 µg/L. PSA in case 2 increased from 9.939 µg/L to 168.536 µg/L, and testosterone increased from 0.0 µg/L increased to 2.85 µg/L. PSA increased from 13.31 µg/L to 39.278 µg/L in case 3, testosterone increased from 0.0 µg/L to 2.54 µg/L. and PSA increased from 36.0 µg/L to 350.2 µg/L in the case 4, testosterone increased from 1.81 µg/L to 3.85 µg/L. Except for one patient who showed significant PSA remission, the PSA levels of the remaining three patients remained high overall. There were no adverse reactions reported in 4 patients. In the follow-up, case 1 continued to use PD-1 monoclonal antibody (median progression free survival time was 10 months). Two patients who had previously been resistant to enzalutamide received enzalutamide again after the whole cycle of treatment, and their PSA decreased again, which indicated that the patient was sensitive to enzalutamide again. BAT had a certain therapeutic effect on mCRPC patients, and the safety was controllable. Its tumor control effect still needed long-term follow-up verification in large-sample clinical trials. BAT has a certain therapeutic effect on mCRPC patient, especially the resensitivity of tumors to enzalutamide can be restored. Immune checkpoint inhibitors may have therapeutic potential in patients with prostate cancer treated with BAT and enzalutamide.

[Application of urethral pressure profilometry in artificial urinary sphincter implantation].

Objective: To investigate the changes of maximum urethral pressure (MUP) and maximum urethral closure pressure (MUCP) after artificial urethral sphincter (AUS) implantation and their prognostic value. Methods: The clinical data of patients who had undergone AUS implantation in multiple medical centers between March and July 2019 were retrospectively analyzed. Data of urethral pressure profilometry, pad usage, related scores and complications related to surgery were collected and compared. The primary endpoint was social continence (defined as 0-1 pad/d) 1 month after activation of the pump. Results: A total of five male patients were included in this study. Two underwent transurethral resection of the prostate for benign prostatic hyperplasia, two underwent radical prostatectomy for prostate cancer, and one underwent urethral reunion, urethral stricture dilatation and cystostomy due to trauma from traffic accident. All patients had different degrees of urinary incontinence. The results of preoperative urethral profilometry test showed that the MUP of five patients were 52, 53, 88, 32, and 66 cmH(2)O(1 cmH(2)O=0.098 kPa), respectively, and the MUCP were 17, 52, 62, 27, and 40 cmH(2)O, respectively. AUS implantation was performed. The intraoperative urethral pressure profilometry showed that the MUP were 53, 113, 50, 77, and 89 cmH(2)O in the inactivated state, and the MUCP were 50, 97, 31, 71, and 51 cmH(2)O, respectively. In the activated state, the MUP were 112, 174, 193, 121, and 120 cmH(2)O, and the MUCP were 109, 160, 175, 114, and 92 cmH(2)O, respectively. All patients met the social continence (0-1 pad/d) criterion. No complications were reported during the follow-up. Conclusions: The relationship between the range of intraoperative urethral pressure and the effect of urinary control can be gained by measuring the specific values of MUP and MUCP during AUS implantation and the post-operative effects, which provides as a data basis for standardizing AUS implantation.

CN and C2 formation mechanisms in fs-laser induced breakdown of nitromethane in Ar or N2 atmosphere.

We investigate atomic and molecular emission of laser-ablated nitromethane in an Ar or N2 buffer gas, with fs laser-induced breakdown spectroscopy. The electronic bands of CN, C2, and NH molecules and the atomic transition lines of C I, N I, and Hα are identified. The time series of the emissions are obtained, and the formation mechanisms of CN and C2 are deduced. The CN violet system, the B2Σ+-X2Σ+ (0-0) band, is chosen to extract plasma temperature from the experimental spectra.

Research on correlations of magnetic resonance imaging features and pathological changes in liver cancer with Beclin1 expression.

OBJECTIVE: Our study aims to explore the correlations of magnetic resonance imaging (MRI) features and pathological changes in liver cancer with the messenger ribonucleic acid (mRNA) and protein expression of Beclin1. PATIENTS AND METHODS: The mRNA and protein expression levels of Beclin1 in 42 cases of liver cancer and para-carcinoma tissues from liver cancer patients were detected via fluorescence quantitative polymerase chain reaction (FQ-PCR) and immunohistochemistry, and its correlations with the clinicopathological characteristics and MRI features were analyzed. RESULTS: The mRNA expression of Beclin1 in liver cancer tissues was significantly higher than that in para-carcinoma tissues, and statistical correlation between pathological grade and mass size of liver cancer was found (p < 0.05). The immunohistochemical results revealed that the Beclin1 positive expression was mainly located in the cytoplasm, and the level was significantly increased compared with that in corresponding para-carcinoma tissues (p < 0.05). The MRI showed that both Min-apparent diffusion coefficient (ADC) and Mean-ADC in Beclin1 high-expression group were significantly lower than those in Beclin1 low-expression group. CONCLUSIONS: The Beclin1 expression plays an important role in the occurrence and development of liver cancer. MRI shows significant correlation with the level of Beclin1 in liver cancer, which provides certain value in the evaluation of the biological behaviors and prognosis of liver cancer.

Capture Deformation Twinning in Mg during Shock Compression with Ultrafast Synchrotron X-Ray Diffraction.

Deformation twinning plays a vital role in accommodating plastic deformation of hexagonal-close-packed (hcp) metals, but its mechanisms are still unsettled under high strain rate shock compression. Here we investigate deformation twinning in shock-compressed Mg as a typical hcp metal with in situ, ultrafast synchrotron x-ray diffraction. Extension twinning occurs upon shock compression along ⟨112[over ¯]0⟩ and ⟨101[over ¯]0⟩, but only upon release for loading along ⟨0001⟩. Such deformation mechanisms are a result of the polarity of deformation twinning, which depends on directionality and relative magnitude of resolved shear stress and may be common for Mg and its alloys in a wide range of strain rates.

Microbial diversity in raw milk and traditional fermented dairy products (Hurood cheese and Jueke) from Inner Mongolia, China.

Hurood cheese (HC) and Jueke (Jk) are 2 traditional fermented dairy products produced from raw milk (RM) in the Inner Mongolia region of China. They have a long history of production and consumption. The microbial compositions of RM, HC, and Jk vary greatly, and are influenced by their geographical origins and unique processing methods. In this study, 2 batches of RM, HC, and Jk samples were collected (April and August 2015) from the Zhenglan Banner, a region located in the southern part of Inner Mongolian belonging to the Xilingol league prefecture. The bacterial and fungal diversities of the samples were determined by 16S rRNA and 18S rRNA gene sequence analysis, respectively. A total of 112 bacterial and 30 fungal sequences were identified, with Firmicutes and Ascomycota being the predominant phyla for bacteria and fungi, respectively. Lactococcus and Lactobacillus were identified as the main bacterial genera, whereas Kluyveromyces was the predominant fungus identified in the 3 dairy products. Different bacterial and fungal compositions were observed in RM, HC, and Jk samples collected at different times. These results suggested that time of production may be an important factor influencing the microbial diversity present in RM, HC, and Jk.

[Value of prostate volume, PSAD and F/T in the detection of prostate cancer in males with PSA 4-10 µg/L].

OBJECTIVE: To evaluate the association of prostate volume, PSAD and F/T with prostate cancer detection rate in males with a total PSA of 4-10 µg/L. METHODS: Clinical data of 196 patients who underwent prostate biopsy from November 2006 to September 2010 and with a PSA of 4-10 µg/L were retrospectively analyzed. The association of detection rate of prostate cancer with prostate volume, prostate specific antigen density PSAD) and free PSA/total PSA ratio (F/T) was analyzed by Spearman coefficient, receiver operating characteristic curve and logistic regression analysis. RESULTS: The prostate volume, PSAD and F/T had a significant association with detection rate of prostate cancer (P<0.05 for all). The odd ratio was 0.96, 1.91 and 0.02, respectively. The area under curve (AUR) was 0.31, 0.66 and 0.63, respectively. The cancer detection rate was decreased along with the increase of prostate volume. When PSAD 0.15 ng·ml(-1)·ml(-1) was used as the cut-off value, the sensitivity, specificity, positive prediction rate and negative prediction rate was 72.3%, 51.1%, 42.3% and 21.2%, respectively. When the patients were divided by prostate volume into <19.9, 20-39.9, 40-59.9, 60-79.9 and >80 ml subgroups, the cancer detection rate of each subgroup was 50.0%, 45.6%, 30.8%, 15.4% and 5.6%, respectively. CONCLUSION: In patients with a total PSA of 4-10 µg/L, the prostate cancer detection rate has a significant association with prostate volume, PSAD and F/T.

Expression of a GDP-L-galactose phosphorylase-like gene in a Chinese wild Vitis species induces responses to Erysiphe necator and defense signaling molecules.

Using rapid amplification of cDNA ends, a full-length cDNA sequence of a GDP-L-galactose phosphorylase-like gene was isolated from leaves infected by Erysiphe necator in the Chinese wild (Vitis pseudoreticulata) clone, 'Baihe-35-1', an E. necator-resistant genotype. The full-length cDNA, designated as VpVTC, comprised 1943 bp and putatively encodes a 453-amino acid polypeptide containing an HIT motif. The deduced amino acid sequence showed high similarity with that of VTC genes from other plants. The expression of VpVTC, determined by reverse transcriptase-polymerase chain reaction, was induced by E. necator and defense signaling molecules, including salicylic acid, methyl jasmonate, and ethephon, in 'Baihe-35-1', the V. quinquangularis genotype 'Shang-24', and the E. necator-susceptible V. pseudoreticulata genotype, 'Hunan-1'. Transcript levels of VpVTC correlated well with the degree of disease resistance in the 3 genotypes. Maximum induction of VpVTC by E. necator (>7-fold at 96 h post-inoculation) occurred in 'Baihe-35-1', which also showed the fastest response to signaling molecules. Upregulating the expression of VpVTC in 'Baihe-35-1' resulted in a gradual increase in the ascorbic acid concentration of leaves inoculated with E. necator. Furthermore, VpVTC was expressed in leaves, stems, inflorescence, tendrils, and fruit at all developmental stages, with the highest level occurring in fruit 35 days after flowering.

Long-term dentofacial changes in Chinese obstructive sleep apnea patients after treatment with a mandibular advancement device.

The objective of this study was to evaluate long-term dentofacial changes in Chinese obstructive sleep apnea (OSA) patients treated with a mandibular advancement device (MAD). Lateral cephalograms in natural head posture were obtained from 67 consecutive OSA patients (mean age = 46.9 +/- 8.9 years) treated with an MAD. The cephalograms were obtained at start of treatment (T0), after 1 year (T1), 2 years (T2), and 3 years (T3) of treatment. The lateral cephalograms were digitized twice, and the average of two readings was used for statistical analyses. Small, but statistically significant changes occurred in some dentofacial variables. The lower anterior facial height steadily increased during the observation period, and this increase was significant for the T0-T1 and T1-T2 periods and marginally significant for the T2-T3 period. A significant increase in the mandibular plane angle was observed during the T0-T1 and T2-T3 periods only. Significant reductions in the overjet and overbite were observed for the T0-T1 period but not thereafter. Statistically significant dentofacial changes were observed in this study, but they were of small magnitude. The overjet and overbite changes observed mainly occurred at the initial stage of treatment.

Naltrexone microspheres: in vitro release and effect on morphine analgesia in mice.

AIM: To study in vitro release and in vivo effect of four different types of sustained-release naltrexone microspheres on morphine analgesia. METHODS: Release of naltrexone from four types of biodegradable microspheres was investigated by HPLC. Their antagonist effects on morphine analgesia were observed using mouse hot-plate procedure. RESULTS: Poly latide-co-glycolide (PLGA) composition had a remarkable effect on naltrexone release from microspheres and its antagonism towards morphine analgesia. Two formulations of PLGA 50:50 formulation released more than 80 % of total naltrexone and lost their antagonism by 8 d. The PLGA 75:25 formulation with 20 % and 30 % drug loadings did not release 95 % of total drug and lose antagonism until 40 d and 30 d, respectively. Increasing the drug loading enhanced naltrexone release from microspheres and seemed to shorten the analgesic antagonistic effect of naltrexone. CONCLUSION: Antagonism by naltrexone microspheres towards morphine analgesia correlates well with the drug release in vitro.

Improvement of transdermal permeation of captopril by iontophoresis.

AIM: The feasibility of iontophoresis on the transdermal delivery of captopril was studied. METHODS: Iontophoresis was employed for enhancing transdermal transport of captopril through rat skin in vitro and in vivo. RESULTS: It was demonstrated that the iontophoresis-induced flux of captopril was affected by various factors such as pH, ionic concentration, and the concentration of captopril in donor compartments as well as the applied electric current intensity. Electric current could induce several-fold increase in captopril flux with hydrogel. Skin permeation study in vivo in rats demonstrated that iontophoresis could effectively promote the transdermal transport of captopril without significant skin irritation. Captopril concentration in plasma reached plateau (approximately 0.9 microgram/mL) at 1 h after current application and was maintained at the same level during the experiment. On the contrary, captopril could not be detected in plasma when the current was not applied. No obvious skin irritation was observed after 9-h continuous iontophoresis. CONCLUSION: Transdermal delivery of captopril can be effectively improved by iontopophoresis.

[Pharmacokinetics and pharmacodynamics of diltiazem floating tablets].

Floating tablet is a new type of delayed-action preparations. The present study was aimed at pharmacokinetic and hemodynamic effects of diltiazem floating tablet in 8 healthy volunteers. Each subject received po 90 mg diltiazem floating and normal tablets in a crossover design. For floating tablets the T1/2 (6.4 +/- 4.4 h) and Cmax (56 +/- 23 ng.ml-1) were longer and lower than those of normal tablets (2.3 +/- 1.1 h and 96 +/- 30 ng.ml-1, P < 0.01), respectively. AUC of the 2 forms were similar, suggesting that they had same bioavailability. Diltiazem lowered the blood pressure of the subjects. Although there was no significant difference between the 2 formulations in maximal decreases of systolic and diastolic blood pressures, the duration of hypotension was longer with floating tablets than that with normal ones. There was a positive correlation between diltiazem concentration and its hypotensive action. Thus, administration of floating tablets twice a day may be effective in controlling the blood pressure of hypertensive patients.